Morton Emma, Michalak Erin E, Murray Greg
Swinburne University of Technology, Psychological Sciences and Statistics, Australia.
University of British Columbia, Department of Psychiatry, Canada.
J Affect Disord. 2017 Apr 1;212:128-137. doi: 10.1016/j.jad.2017.01.026. Epub 2017 Jan 23.
Quality of life (QoL) is increasingly investigated in bipolar disorders (BD) research, yet little attention has been paid to its optimal definition and measurement. This is a significant limitation, as the broader QoL literature recognises a number of divergent meanings and measurement tensions. The aim here was to advance understanding of QoL in BD by clarifying use of the construct in the existing literature and considering measurement implications.
Thematic analysis techniques were used to interrogate articles identified via systematic search for (a) explicit discussion of QoL definitional/measurement issues, and (b) usage of the term QoL.
A total of 275 articles were included in the analysis. A range of definitional and methodological issues confounding the study of QoL in BD were identified. While explicit definition of QoL proved rare, thematic analysis of usage of the construct revealed the concepts of functioning, health, subjective experience and wellbeing were thought to be relevant to QoL in BD.
The review does not engage in top-down theory development. Our analysis was grounded in the empirical literature to support future theoretical work relevant to existing usage of QoL in BD.
There was no evidence of a consensus definition of QoL in BD. A plurality of QoL definitions is not necessarily a flaw in the literature, but points to empirical and conceptual issues demanding attention. Awareness of the diversity of constructs associated with QoL will enable clinicians to better select treatments on the basis of specific QoL outcomes. A research agenda and provisional considerations for empirical research are outlined based on the present analyses.
在双相情感障碍（BD）研究中，生活质量（QoL）越来越受到关注，但对其最佳定义和测量方法却鲜有重视。这是一个重大局限，因为更广泛的生活质量文献认识到了一些不同的含义和测量方面的矛盾。本文旨在通过澄清现有文献中该概念的使用情况并考虑测量方面的影响，来增进对双相情感障碍中生活质量的理解。
采用主题分析技术对通过系统检索确定的文章进行研究，这些文章需满足以下条件：（a）明确讨论生活质量的定义/测量问题，以及（b）使用“生活质量”一词。
共有275篇文章纳入分析。确定了一系列混淆双相情感障碍中生活质量研究的定义和方法问题。虽然对生活质量的明确定义很少见，但对该概念使用情况的主题分析表明，功能、健康、主观体验和幸福感等概念被认为与双相情感障碍中的生活质量相关。
本综述未进行自上而下的理论发展。我们的分析基于实证文献，以支持未来与双相情感障碍中生活质量现有用法相关的理论工作。
没有证据表明双相情感障碍中存在生活质量的共识定义。生活质量定义的多样性不一定是文献中的缺陷，但指出了需要关注的实证和概念问题。认识到与生活质量相关的概念的多样性将使临床医生能够根据特定的生活质量结果更好地选择治疗方法。基于目前的分析，概述了一个研究议程和实证研究的初步考虑因素。
